Randomized Comparison of Helmet CPAP Versus High-Flow Nasal Cannula Oxygen in Pediatric Respiratory Distress

Document Type

Article

Abstract

BACKGROUND: The current study aimed to compare the efficacy and safety of 2 noninvasive respiratory support methods, which included helmet CPAP and high-flow nasal cannula (HFNC) in children with respiratory distress admitted to a pediatric intermediate care unit. METHODS: This study was a prospective observational study conducted on children with respiratory distress (age 1-24 months) who were admitted to our acute and emergency operative unit. All included subjects were randomly treated with helmet CPAP or HFNC in a 1:1 fashion until their clinical picture, oxygen saturation, and arterial blood gas (ABG) parameters resolved. The efficiencies of helmet CPAP and HFNC were evaluated by breathing frequency, S , ABG pH, ABG P , ABG P , and P /F , recorded once at baseline and then after 1 and 6 h of treatment. Both noninvasive respiratory support modalities were compared with a control group of subjects with respiratory distress under standard therapeutic pharmaceutical protocols. RESULTS: We found that both helmet CPAP and HFNC were efficient in improving the clinical conditions of subjects with mild-to-moderate respiratory distress, although clinical response to helmet CPAP was more efficient and rapid compared with HFNC. Children who received respiratory support had a better clinical course in terms of hospitalization, days of intravenous rehydration therapy, and days of drug administration compared with the control group ( < .001). CONCLUSIONS: Based on our knowledge, the present study is the first research comparing the effects of CPAP and HFNC in respiratory distress resolution in a pediatric intermediate care setting. It aims to identify the most efficient treatment to avoid pediatric ICU admissions and endotracheal intubation and reduce the administration of drugs and days of hospitalization.

Medical Subject Headings

Blood Gas Analysis; Cannula; Continuous Positive Airway Pressure (instrumentation, methods); Female; Humans; Infant; Infant, Newborn; Male; Noninvasive Ventilation (instrumentation, methods); Oxygen Consumption; Oxygen Inhalation Therapy (instrumentation, methods); Prospective Studies; Respiratory Distress Syndrome, Newborn (physiopathology, therapy); Treatment Outcome

Publication Date

8-1-2017

Publication Title

Respiratory care

E-ISSN

1943-3654

Volume

62

Issue

8

First Page

1036

Last Page

1042

PubMed ID

28487415

Digital Object Identifier (DOI)

10.4187/respcare.05384

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